Notes on Women's Health
Notes on Women's Health

Uterine Fibroids: Your Questions Answered

This is the second in a series of five blogs about common conditions that can cause abnormal uterine bleeding.

uterine-fibroids-woman-painUterine Fibroids: A common condition

Of every 10 women who come into our practice, seven of them will have uterine fibroids at some point in their lives. Uterine fibroids are that common. But despite their frequency, many women have questions about fibroids, especially when the condition affects quality of life or causes health issues. Here are answers to some of the fibroid questions we’re asked most often at our practice.

What are fibroid tumors?

Fibroids are noncancerous tumors that grow in or next to the uterus, which is the hollow, pear-shaped organ where the embryo and fetus develop. They can occur as a single fibroid or there can be two or more. They are usually diagnosed and treated in women between the ages of 35 and 54, but they can occur in women as young as their early 20s.

Fibroids can grow in the uterine wall or they can form outside the uterus, attached by a stem. They can grow slowly, quickly or not at all, and they can range from the size of a freckle to large enough for a woman to look six or seven months pregnant.

What are fibroid tumor symptoms?

While not all women who have fibroid tumors experience symptoms or need to seek relief, some women may experience a wide range of symptoms. These can include:

  • abnormal uterine bleeding (including heavy bleeding or long menstrual periods)
  • anemia
  • pelvic pain, nausea or fever
  • frequent urination
  • constipation
  • infertility
  • miscarriages
  • belly bumps

These symptoms are sometimes divided into two categories: abnormal uterine bleeding and “bulk” symptoms. Bulk symptoms, which include pelvic pain and frequent urination, can be caused by large fibroids.

How are uterine fibroids treated?

Generally speaking, if there are no symptoms then no treatment is needed. But if fibroids are painful, if they affect quality of life, or if they interfere with pregnancy, there are a few treatments that can be considered. Treatment options can depend on whether the worst symptoms are related to bleeding, fibroid size or location, or a combination of factors. Another thing to consider is your age: Since fibroids often shrink or disappear during menopause, treatment decisions can be affected by how close you are to menopause.

Women with uterine fibroids have several medical and surgical treatment options. While the medical options can relieve symptoms, they are generally temporary solutions that don’t eliminate fibroids. Here are the main medical options:

  • Hormonal birth control. The first choice of many women, hormones reduce bleeding by thinning the endometrium (the lining of the uterus that is shed during a woman’s period).
  • Gonadotropin-releasing hormone agonists. Also called GnRH agonists, these medications can shrink fibroids, but fibroids grow back once the treatment is stopped, and these drugs are not intended for long-term use.
  • Non-hormonal medications. Medications such as Lysteda can reduce heavy bleeding by helping blood to clot.

There are also several surgical options to uterine fibroids. Here are a few of the main ones:

  • Hysteroscopic myomectomy. In this procedure, a thin tube called an endoscope is passed through the cervix and into the uterus. Fibroids are shaved and removed but the uterus is left intact.
  • Myomectomy. Conducted through a larger incision in the abdomen, this procedure can also reduce fibroid size while preserving the ability to have children. Fibroids can recur after either type of myomectomy.
  • Endometrial ablation. With this procedure, which is only for women who no longer want to have children, the endometrium is destroyed, often with heat or cold.
  • Uterine artery embolization. This procedure blocks the blood supply to fibroids, causing them to shrink and die.
  • MRI-guided ultrasound surgery. This approach uses ultrasound waves to shrink fibroids and reduce heavy menstrual bleeding.
  • Hysterectomy. Also known as the surgical removal of the uterus, this approach also has the effect of removing existing fibroids and preventing new fibroids from forming. Hysterectomies can often be done laparascopically (through small incisions). This procedure is only for women who no longer want to have children. With this approach, recovery is quicker and there are usually fewer complications compared to a traditional hysterectomy.

Which fibroid treatment is best?

As you can see, there are many treatment options for uterine fibroids. This means that you and your healthcare provider can work together to choose a treatment based on your preferences, your family plans, and any other medical considerations. Your healthcare provider should be able to discuss all these options, as well as their risks and benefits.

The best treatment for you may depend on several factors, including:

  • which symptoms are bothering you the most and how they affect your quality of life
  • whether you plan to have any more children
  • if you’d prefer to keep your uterus, even if you’re done having children

It’s a lot of factors to consider, but remember: Although there’s no “best” treatment for uterine fibroids, there’s probably a best treatment for your situation.

Additional information

If you have any questions about abnormal uterine bleeding or uterine fibroids, feel free to contact us for more information or schedule a new patient consultation to discuss your particular situation. More information can be found below.
Dr. John M. Garofalo, M.D.: uterine fibroids
American Congress of Obstetricians and Gynecologists: frequently asked questions on uterine fibroids

About the practice

Dr. John Garofalo, M.D., is an ob-gyn located in Fairfield County, Connecticut. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.

For more information, go to www.garofaloobgyn.com. John Garofalo, MD, and Laury Berkwitt, APRN, can be reached for personal consultations by calling 203.803.1098.